PACES MRCP UK - Where MRCPians Meet Since 2006

MRCP is well establised as an entry exam for advanced specialist training in many countries including Malaysia. It consists of 3 paper i.e. Part1, Part2(written tests) and PACES. PACES in full means Practical Assessment of Clinical Examination Skills. It is the third part and the candidate is assessed by fellows of RCP. I passed my PACES in 2005. I am glad that many seniors had guided me throughout my preparation for PACES and I wish to share my experiences with PACES candidates via this blog.

Friday, June 23, 2006

Spot diagnosis: Acromegaly

Widely spaced teeth

Acromegaly is a gift in endocrine substation. You should not miss the striking features of acromegaly.
**Face-prominent supraorbital ridges,large nose and tongue, increased interdental separation, prognatism.

Then, proceed to look for:
1) Neck for goiter
2) Visual field for bitemporal hemianopia
3) Hand- carpal tunnel syndrome, spade-like hand, thick , doughy hand with thick hand and sweaty palms
4) Skin- look for skin tag over the axilla.
5) Leg- leg odema ( may indicate heart failure)

Lastly, tell examiners that, you would
1) check abdomen for hepato-splenomegaly and look for testicular atrophy
2) Check BP and urine for sugar
3) Check joint for athropathy
4) Ask for patient's old photo or IC for comparison with current facies features

Tips: As a MRCPian, you are expected to assess the disease activity. Please pay attention to check for sweaty palm, skin tags, visual field and BP.

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At 8/12/2006 05:35:00 PM, Blogger Giant Eagle said...

Carefrully look and feel the forehead for scars (felt as uneven ridging) from previous transfrontal approach surgery. This is especially true in older patients when transphenoidal surgery was not available yet


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